Please use the following form to begin the booking process. Please keep in mind that your party is not confirmed until you speak with a member of our team to verify your information and confirm that the requested date and time are available.

Please list any dates in the next three (3) months in which you are unable to work:*

EDUCATION HISTORY

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HIGH SCHOOL

Name of School

Location

Graduate?

Yes

No

Years Attended

Subjects Studied

COLLEGE

Name of School

Location

Graduate?

Yes

No

Years Attended

Subjects Studied

OTHER

Name of School

Location

Graduate?

Yes

No

Years Attended

Subjects Studied

EMPLOYMENT HISTORY

Current/Most Recent Employer

Name of Employer

Position

Current Employer?

Yes

Supervisor's Name

Supervisor's Phone

Start Date

End Date

Reason for leaving?

Starting Salary

Ending Salary

Responsibilities

Previous Employer

Name of Employer

Position

Supervisor's Name

Supervisor's Phone

Start Date

End Date

Reason for leaving?

Starting Salary

Ending Salary

Responsibilities

Previous Employer

Name of Employer

Position

Supervisor's Name

Supervisor's Phone

Start Date

End Date

Reason for leaving?

Starting Salary

Ending Salary

Responsibilities

PROFESSIONAL REFERENCES

Name

Phone

Relationship + Years Known

Name

Phone

Relationship + Years Known

Name

Phone

Relationship + Years Known

Release and Authorization

I hereby authorize The Mad Potter and their agents to conduct an investigation into my background and qualifications. Such investigations include, but are not limited to, obtaining reports from credit reporting agencies, courts, corporations, companies, individuals, educational institutions, and government agencies. I hereby release all parties and The Mad Potter from liability arising from such an investigation. I hereby authorize my former employer to release to The Mad Potter and their agents any personnel information and records, favorable and otherwise, which my employer has kept regarding my employment, including my work performance. I understand that The Mad Potter may retain photocopies of my records for its files, whether I am offered employment or not. I hereby release all parties, including my former employer and The Mad Potter from any liability arising from the release, review and retention of any records pertaining to me. I acknowledge that The Mad Potter and their agents reserve the right to investigate the correctness of information in such reports concerning me. I understand that The Mad Potter and their agents may rely on and base its employment decisions solely upon information contained in such reports I release. I further release The Mad Potter and their agents harmless from any liability arising from their reliance upon any information obtained from any source. If I am hired, I agree that my employment and compensation can be terminated with or without cause and without notice at any time, at the option of The Mad Potter.